Acne keloidalis: a novel presentation for tinea capitis

Area of Science:

• Dermatology
• Mycology
• Clinical Case Reports

Background:

• Acne keloidalis is an inflammatory scalp condition characterized by follicular papules and pustules, progressing to keloid-like scarring, predominantly affecting adult males.
• Tinea capitis, a fungal infection of the scalp, can present with diverse clinical manifestations, including inflammatory and non-inflammatory lesions.

Observation:

• A 60-year-old female presented with firm, skin-colored papules on the neck and scalp, clinically resembling acne keloidalis.
• Microscopic examination and fungal culture confirmed the diagnosis of tinea capitis, not acne keloidalis.

Findings:

• The patient's scalp lesions, initially mimicking acne keloidalis, were successfully treated with oral antifungal medication.
• This case highlights the potential for tinea capitis to present atypically, mimicking other common scalp dermatoses.

Implications:

• Dermatologists should consider fungal infections in the differential diagnosis of scalp papular lesions, even when the presentation suggests other conditions like acne keloidalis.
• Prompt diagnosis and appropriate antifungal therapy are crucial for resolving tinea capitis and preventing complications.